Tan Sita Y G L, van Oortmarssen Gerrit J, de Koning Harry J, Boer Rob, Habbema J Dik F
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
J Natl Cancer Inst Monogr. 2006(36):56-65. doi: 10.1093/jncimonographs/lgj009.
The MISCAN-Fadia model was used to analyze the impact of screening and adjuvant treatment on U.S. breast cancer mortality between 1975 and 2000. MISCAN-Fadia uses the concept of "fatal diameter" to model survival and screening benefit and is based on continuous tumor growth. It consists of four major components: population, natural history, screening, and treatment. Population parameters were quantified using U.S. population data. Most natural history and screening parameters were fitted to the Swedish Two County screening trial data; some were based on Surveillance, Epidemiology, and End Results data. Adjuvant treatment parameters were quantified using data from the Early Breast Cancer Trialists' Collaborative Group's meta-analysis. The simulated trend in incidence matches the observed trend reasonably well; the simulated mortality is equal to the observed in 1975 but becomes increasingly too high in 2000. We estimate that screening leads to a 15% and adjuvant treatment to a 21% mortality reduction in the year 2000.
MISCAN-Fadia模型用于分析1975年至2000年间筛查和辅助治疗对美国乳腺癌死亡率的影响。MISCAN-Fadia采用“致命直径”概念对生存情况和筛查效益进行建模，且基于肿瘤的持续生长。它由四个主要部分组成：人群、自然史、筛查和治疗。人群参数通过美国人口数据进行量化。大多数自然史和筛查参数根据瑞典双县筛查试验数据进行拟合；部分参数基于监测、流行病学和最终结果数据。辅助治疗参数通过早期乳腺癌试验者协作组的荟萃分析数据进行量化。模拟的发病率趋势与观察到的趋势相当吻合；模拟死亡率在1975年与观察值相等，但在2000年变得越来越高。我们估计，在2000年，筛查使死亡率降低了15%，辅助治疗使死亡率降低了21%。
